11.11 Other Options for Individuals with Medicare

Employer Group Health Plans

Disabled employees who are under age 65 and not retired must be covered under a large group health plan (100 or more employees).

For individuals eligible for Medicare due to End-Stage Renal Disease (ESRD), the employer group health plan remains the primary payer for the first 30 months of coverage. After this period, Medicare becomes the primary payer.

Individuals age 65 or older who continue working may remain covered under an employer group health plan. If the employer has 20 or more employees, the group plan is primary and Medicare is secondary. If the employer has fewer than 20 employees, Medicare is the primary payer.